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Smith IC, Pileggi CA, Wang Y, Kernohan K, Hartley T, McMillan HJ, Sampaio ML, Melkus G, Woulfe J, Parmar G, Bourque PR, Breiner A, Zwicker J, Pringle CE, Jarinova O, Lochmüller H, Dyment DA, Brais B, Boycott KM, Hekimi S, Harper ME, Warman-Chardon J. Novel Homozygous Variant in COQ7in Siblings With Hereditary Motor Neuropathy. Neurol Genet 2023; 9:e200048. [PMID: 37077559 PMCID: PMC10108386 DOI: 10.1212/nxg.0000000000200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/19/2022] [Indexed: 01/26/2023]
Abstract
Background and ObjectivesCoenzyme Q10(CoQ10) is an important electron carrier and antioxidant. The COQ7 enzyme catalyzes the hydroxylation of 5-demethoxyubiquinone-10 (DMQ10), the second-to-last step in the CoQ10biosynthesis pathway. We report a consanguineous family presenting with a hereditary motor neuropathy associated with a homozygous c.1A > G p.? variant ofCOQ7with abnormal CoQ10biosynthesis.MethodsAffected family members underwent clinical assessments that included nerve conduction testing, histologic analysis, and MRI. Pathogenicity of theCOQ7variant was assessed in cultured fibroblasts and skeletal muscle using a combination of immunoblots, respirometry, and quinone analysis.ResultsThree affected siblings, ranging from 12 to 24 years of age, presented with a severe length-dependent motor neuropathy with marked symmetric distal weakness and atrophy with normal sensation. Muscle biopsy of the quadriceps revealed chronic denervation pattern. An MRI examination identified moderate to severe fat infiltration in distal muscles. Exome sequencing demonstrated the homozygousCOQ7c.1A > G p.? variant that is expected to bypass the first 38 amino acid residues at the n-terminus, initiating instead with methionine at position 39. This is predicted to cause the loss of the cleavable mitochondrial targeting sequence and 2 additional amino acids, thereby preventing the incorporation and subsequent folding of COQ7 into the inner mitochondrial membrane. Pathogenicity of theCOQ7variant was demonstrated by diminished COQ7 and CoQ10levels in muscle and fibroblast samples of affected siblings but not in the father, unaffected sibling, or unrelated controls. In addition, fibroblasts from affected siblings had substantial accumulation of DMQ10, and maximal mitochondrial respiration was impaired in both fibroblasts and muscle.DiscussionThis report describes a new neurologic phenotype ofCOQ7-related primary CoQ10deficiency. Novel aspects of the phenotype presented by this family include pure distal motor neuropathy involvement, as well as the lack of upper motor neuron features, cognitive delay, or sensory involvement in comparison with cases ofCOQ7-related CoQ10deficiency previously reported in the literature.
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Affiliation(s)
- Ian C Smith
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Chantal A Pileggi
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Ying Wang
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Kristin Kernohan
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Taila Hartley
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Hugh J McMillan
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Marcos Loreto Sampaio
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Gerd Melkus
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - John Woulfe
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Gaganvir Parmar
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Pierre R Bourque
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Ari Breiner
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Jocelyn Zwicker
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - C Elizabeth Pringle
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Olga Jarinova
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Hanns Lochmüller
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - David A Dyment
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Bernard Brais
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Kym M Boycott
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Siegfried Hekimi
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Mary-Ellen Harper
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Jodi Warman-Chardon
- The Ottawa Hospital Research Institute (I.C.S., M.L.S., G.M., A.B., J.Z., H.L., J.W.-C.), Ottawa; Department of Biochemistry, Microbiology and Immunology (C.A.P., G.P., M.-E.H.), Faculty of Medicine, University of Ottawa, Ontario; Ottawa Institute of Systems Biology (C.A.P., G.P., M.-E.H.), University of Ottawa, Ontario; Department of Biology (Y.W., S.H.), McGill University, Montreal, Quebec; Children's Hospital of Eastern Ontario Research Institute (K.K., T.H., O.J., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; Newborn Screening Ontario (K.K.), Ottawa; Departments of Pediatrics, Neurology, & Neurosurgery (H.J.M.), Montreal Children's Hospital, McGill University, Montreal, Quebec; Department of Radiology, Radiation Oncology and Medical Physics (M.L.S., G.M.), University of Ottawa, Ontario; Department of Laboratory Medicine (J.W.), The Ottawa Hospital, Ontario; Department of Medicine (Neurology) (P.R.B., A.B., J.Z., E.P., C.E.P., H.L., J.W.-C.), The Ottawa Hospital, Ontario; Faculty of Medicine/Brain and Mind Research Institute (A.B., H.L., D.A.D., K.M.B., J.W.-C.), University of Ottawa, Ontario; and Department of Neurology and Neurosurgery (B.B.), Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
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